经直肠实时组织弹性成像联合灰阶超声诊断前列腺周围区病灶的价值  

Transrectal real-time tissue elastography combined with grey-scale ultrasound:Valuable for the diagnosis of prostate peripheral zone lesions

作　　者：张艳[1] 唐杰[1] 李岩密[1] 费翔[1] 李志艳[1] 

机构地区：[1]解放军总医院超声科,北京100853

出　　处：《中华男科学杂志》2010年第11期979-983,共5页National Journal of Andrology

基　　金：国家自然科学基金(30772179)~~

摘　　要：目的:探讨经直肠实时组织弹性成像(TRTE)应变图分类方法联合经直肠超声(TRUS)在前列腺周围区病灶鉴别诊断中的价值。方法:对145例怀疑前列腺癌患者行TRUS检查与TRTE检查,根据病灶内的应变图特点,将其分为5级,并与病理结果对照。结果:145例中124例(52例恶性,72例良性)弹性成像质量好。应变图Ⅰ～Ⅴ级中恶性比例分别为6.8%、23.1%、31.3%、75.6%、100%。TRTE诊断前列腺周围区病灶的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为88.5%、70.8%、78.2%、68.7%和89.5%;而TRTE与TRUS联合诊断后分别为78.8%、86.1%、83.1%、80.4%和84.9%。结论:病灶内应变图分类联合TRUS在前列腺周围区病灶鉴别诊断中具有重要价值。Objective：To investigate the value of strain patterns by transrectal real-time tissue elastography（TRTE）combined with transrectal ultrasonography（TRUS）in the differential diagnosis of the peripheral zone lesions of the prostate.Methods：A total of 145 patients suspected of prostate cancer（PCa）underwent TRUS and TRTE examinations.Based on the features of the strain patterns,the lesions were classified into 5 grades,and the strain patterns were compared with the results of pathological diagnosis.Results：High-quality images of TRTE were obtained in 124（52 malignant and 72 benign）of the cases.According to the pathological results,malignancies accounted for 6.8%（3/44）in GradeⅠ,23.1%（3/13）in GradeⅡ,31.3%（5/16）in Grade Ⅲ,75.6%（31/41）in Grade Ⅳ and 100%（10/10）in Grade Ⅴ,with statistically significant differences among the 5 grades（χ2 = 57.9,P 0.01）,and the diagnostic sensitivity,specificity,accuracy,positive predictive value（PPV）and negative predictive value（NPV）were 88.5%,70.8%,78.2%,68.7% and 89.5% for TRTE,in comparison with 78.8%,86.1%,83.1%,80.4% and 84.9% for the combination of TRTE and TRUS.Conclusion：The combined use of strain patterns and TRUS is helpful to the differential diagnosis of prostate peripheral zone lesions.

关 键 词：前列腺癌 弹性成像 超声 诊断 

分 类 号：R737.25[医药卫生—肿瘤] R445.1[医药卫生—临床医学]